Rimmer M G, Nawana N S, Keene G C, Pearcy M J
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, South Australia.
Arthroscopy. 1995 Apr;11(2):146-50. doi: 10.1016/0749-8063(95)90059-4.
The aim of this study was to measure the failure strengths of three arthroscopic meniscal suturing methods. The techniques investigated were a single horizontal loop, a double vertical loop, and a single vertical loop. Eleven human, lateral menisci obtained at autopsy were cut with a scalpel to simulate peripheral longitudinal tears. The menisci were then repaired with one suture at a time, using each of the three methods in turn. The two parts of the meniscus were then pulled apart using a computer-controlled materials testing machine until failure occurred, either by the suture itself failing or by the suture pulling out because of tearing of the meniscus. The horizontal sutures had a mean failure strength of 29.3 N, whereas the double vertical loop failed at 63.2 N and the single vertical loop at 67.3 N. The horizontal loop sutures and the double vertical loop sutures all failed by pulling out of the meniscus. The single vertical loop sutures failed by rupture of the suture itself. This study showed the superior mechanical characteristics of the single vertical loop suturing system over the other techniques tested. Owing to the more consistent failure strength, decreased costs, and shorter surgical time over the double vertical loop system, the single vertical loop technique is recommended for arthroscopic meniscal repair.
本研究的目的是测量三种关节镜下半月板缝合方法的失效强度。所研究的技术为单水平环、双垂直环和单垂直环。从尸检获得的11个外侧半月板用人造手术刀切割,以模拟周边纵向撕裂。然后依次使用三种方法中的每一种,每次用一根缝线对半月板进行修复。然后使用计算机控制的材料试验机将半月板的两部分拉开,直到出现失效,失效原因要么是缝线本身断裂,要么是由于半月板撕裂导致缝线拔出。水平缝线的平均失效强度为29.3N,而双垂直环在63.2N时失效,单垂直环在67.3N时失效。水平环缝线和双垂直环缝线均因从半月板中拔出而失效。单垂直环缝线因缝线本身断裂而失效。本研究表明,单垂直环缝合系统在机械特性上优于其他测试技术。由于与双垂直环系统相比,单垂直环技术的失效强度更一致、成本更低且手术时间更短,因此推荐用于关节镜下半月板修复。